Methods

We performed an observational study of 123 mechanically ventilated patients with extended
hemodynamic monitoring, analyzing process-of-care variables for the first week of
ICU admission. The primary outcome parameter was 28-day mortality. ΔmaxEVLWI indicated the maximum difference between EVLWI measurements during ICU stay.
Patients with a ΔmaxEVLWI <−2 mL/kg were called 'responders'. CLI was defined as C-reactive protein (milligrams
per deciliter) over albumin (grams per liter) ratio and conservative late fluid management
(CLFM) as even-to-negative fluid balance on at least two consecutive days.

Conclusion

There seems to be an important correlation between CLI, EVLWI kinetics, IAP, and fluid
balance in mechanically ventilated patients, associated with organ dysfunction and
poor prognosis. In this context, we introduce the global increased permeability syndrome.